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Exoskeleton-assisted Gait Training in Persons With Multiple Sclerosis: A Single-Group Pilot Study

Published:December 07, 2019DOI:https://doi.org/10.1016/j.apmr.2019.10.192

      Abstract

      Objective

      To investigate the feasibility of conducting exoskeleton-assisted gait training (EGT) and the effects of EGT on gait, metabolic expenditure, and physical function in persons with multiple sclerosis (MS).

      Design

      Single-group pilot study.

      Setting

      Research laboratory in a rehabilitation hospital.

      Participants

      Individuals with MS (N=10; mean age, 54.3±12.4y) and Expanded Disability Status Scale 6.0-7.5.

      Interventions

      All participants completed up to 15 sessions of EGT.

      Main Outcome Measures

      Timed 25-foot walk test at self-selected and fast speed, 6-minute walk test, metabolic expenditure of walking and timed Up and Go test were assessed during walking without the exoskeleton at baseline and immediate post training.

      Results

      All participants tolerated the training intensity and completed training without adverse events. After training, gait speed was improved and metabolic expenditure was reduced significantly during the timed 25-foot walk test at self-selected speed.

      Conclusions

      EGT is not only feasible but may also improve gait efficiency for persons with MS. Our observed improvement in gait speed was associated with reduced metabolic expenditure, which was likely because of improved neuromotor coordination. Further studies are required to investigate the effectiveness and integration of EGT in the continuum of MS rehabilitation.

      Keywords

      List of abbreviations:

      BWSTT (body weight–supported treadmill training), EDSS (Expanded Disability Status Scale), EGT (exoskeleton-assisted gait training), FS (fast speed), MS (multiple sclerosis), NVO2peak (normalized peak oxygen consumption), RAGT (robotic-assisted gait training), T25FW (timed 25-foot Walk), TUG (timed Up and Go), SS (self-selected speed), 6MWT (6-minute walk test), VO2peak (peak oxygen consumption)
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